Indian parents need to look beyond their children’s healthy appearance in order to solve the country’s ‘hidden hunger’ problem, experts say.

India is known for having a double burden of malnutrition, with under-nutrition a problem in rural areas and diabetes and obesity an issue in urban areas.

A lesser known issue in the country is termed ‘hidden hunger’, which refers to under-nutrition that could could hinder physical and cognitive development in children who appear healthy on the surface.

National Neonatology Forum (NNF) Odisha State secretary Dr Ashutosh Mahapatra told Indian media: “Hidden hunger is a term used for micro-nutrient deficiency, like vitamin A, iodine, iron and zinc. Children with these decencies may look chubby and healthy but may fail to achieve their optimum cognitive and physical growth.​

“This is why it is important to make parents aware that filling their children’s tummy is not the only dietary goal. Ensuring their daily intake of micro-nutrients is equally important for their health.”​

What ails the affluent?

Quite often, even seemingly healthy children from well-off families suffer from micro-nutrient deficiencies.

This is usually because parents tend to be insufficiently informed about their children’s nutritional requirements, and do not know that complementary feeding is necessary for them to meet those requirements.

“Considering the importance of micro-nutrients during early childhood and the fact that it is almost impossible to meet their recommended intake with breast milk and traditional food alone, it is important to look for effective and scientifically-validated solutions, including fortified food in their diet,” ​said Mahapatra.

Fortification in the formative years

The first 1,000 days of life are particularly crucial for a child’s physical and cognitive development, with the latter especially significant between eight months and two years of age.

In this period, synapsis — the connection that passes messages among neurons in the brain — undergoes its maximum development, and sufficient micro-nutrient intake is required to support it.

Micro-nutrient deficiency in infants and young children delays mental and motor function development and may result in sub-par intellectual performance, lowered productivity, and poor health in adolescence and adulthood.

Food fortification has been shown to have a sustained impact on children’s growth and development, and is widely recommended in most countries as a component of supplementary food for children up to two years old.

In India, there has been a strong focus​ on food fortification to combat malnutrition, with the Food Safety and Standards Authority of India (FSSAI) taking steps to ensure a higher level of food fortification in the country.